,,ii #aaeth ,,congress #ast ,session ,s4 #baba ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,november #ad1 #bjag,mr4 ,heller 7for himself1 ,mr4 ,bennet1 and ,mr4 ,gardner7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to require reporting of certain data by providers and suppliers of air ambulance services for purposes of reforming reimbursements for such services under the ,medicare program1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,ensuring ,access to ,air ,ambulance ,services ,act of #bjag4 #b4 ,air ambulance data reporting program and value-based purchasing program ,section #ahcd7l7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7l77 is amended-- 7#a7 in paragraph 7#c77;,b71 by striking subparagraph 7,c7 and inserting subparagraph 7,c7 and paragraphs 7#ag7 and 7#bj72 7#b7 in paragraph 7#c77;,c71 by inserting 7other than #bjah7 after each subsequent year2 and 7#c7 by adding at the end the following new paragraphs3 7#ag7 ,air ,ambulance ,data ,reporting ,program 7,a7 ,submission of cost data ,with respect to #bjai and each subsequent year1 each supplier or provider of air ambulance services shall submit to the ,secretary data specified under subparagraph 7,b7 for air ambulance services furnished by such provider or supplier during such year4 ,such data shall be submitted in a form and manner1 and on an annual basis1 as specified by the ,secretary for purposes of this subparagraph4 7,b7 ,cost data ,for purposes of reporting data for air ambulance services furnished during a year1 the data described in this subparagraph are cost data on the following3 7i7 ,maintenance of aircrafts4 7ii7 ,medical supplies and equipment4 7iii7 ,fuel4 7iv7 ,employee expenses4 7v7 ,recurring training relating to aviation1 maintenance1 communication1 and clinical4 7vi7 ,rent and utilities4 7vii7 ,communications4 7viii7 ,travel4 7ix7 ,hull and aviation liability insurance1 life insurance1 and professional malpractice insurance4 7x7 ,marketing4 7xi7 ,supplies and equipment4 7xii7 ,overhead support4 7xiii7 ,aircraft ownership expenses4 7xiv7 ,depreciation4 7xv7 ,safety enhancement capital costs4 7xvi7 ,safety enhancement recurring costs4 7,c7 ,consultation relating to cost reports ,for purposes of this paragraph1 the ,secretary shall consult with suppliers and providers of air ambulance services to develop a cost reporting instrument and further define the data specified under subparagraph 7,b7 through instructions4 7,d7 ,submission of quality data ,with respect to #bjbj and each subsequent year1 each supplier or provider of air ambulance services shall submit to the ,secretary data specified under subparagraph 7,e7 for air ambulance services furnished by such supplier or provider during such year4 ,such data shall be submitted in a form and manner1 and on an annual basis1 as specified by the ,secretary for purposes of this subparagraph4 7,e7 ,quality data ,for purposes of reporting data for air ambulance services furnished during a year1 the data described in this subparagraph are quality data on the following measures3 7i7 ,mechanical ventilator use in patients with advanced airways4 7ii7 ,interpretation of #ab-lead electrocardiogram documented on patient care record for those transported with primary cardiac diagnoses4 7iii7 ,continuous waveform capnography for mechanically ventilated patients4 7iv7 ,advanced airway established without newly developed hypoxia or hypotension4 7v7 ,tracheal intubation verified with capnography and direct visualization1 chest radiograph1 or symmetric breath sounds4 7,f7 ,consequence for not reporting quality data for value-based purchasing 7i7 ,in general ,with respect to ambulance services furnished by a provider or supplier of air ambulance services during a payment year 7beginning with #bjbd71 if such provider or supplier does not submit to the ,secretary data specified under subparagraph 7,e7 for the performance period for such year 7as defined in paragraph 7#bj77;,f771 the ,secretary shall provide for a percent reduction of #aj percent to the percentage increase determined under paragraph 7#c77;,b71 after application of paragraphs 7#c77;,c7 and 7#ai7 for such payment year4 7ii7 ,application ,the reduction under clause 7i7 shall apply only with respect to the year involved and the ,secretary shall not take into account such increase in computing the payment amount under the fee schedule under this subsection for a subsequent year4 7iii7 ,distribution ,for purposes of paragraph 7#bj77;,d77iii77,,iii71 of the total amount of reductions pursuant to clause 7i7 for a payment year-- 7,i7 #ej percent of such reductions shall be made available for purposes of performance payments under paragraph 7#bj7 for such payment year2 and 7,,ii7 #ej percent shall be transferred to the ,federal ,hospital ,insurance ,trust ,fund under section #ahag4 7,g7 ,data disclosures ,the ,secretary shall provide1 with respect to data submitted under subparagraph 7,d7 by a supplier or provider of air ambulance services-- 7i7 with respect to #bjbj1 on a confidential basis to such supplier or provider1 information with respect to such data and year1 including a comparison of the results of such data submitted by such supplier or provider to the national average1 with respect to such data reported2 and 7ii7 with respect to a subsequent year1 for the public disclosure of such information with respect to such subsequent year1 including the comparison described in clause 7i7 of such data with respect to such subsequent year4 7,h7 ,reports 7i7 ,by ,secretary ,not later than ,july #a1 #bjba1 subject to clause 7iii71 the ,secretary shall submit to ,congress a report on the data described in subparagraphs 7,b7 and 7,e7 submitted to the ,secretary4 7ii7 ,by ,comptroller ,general ,not later than ,july #a1 #bjba1 subject to clause 7iii71 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on the data described in subparagraph 7,b7 and subparagraph 7,e7 submitted under this paragraph4 ,such report shall include an analysis of cost variation to providers and supplier of air ambulance services by geography and provider or supplier status and a recommendation on the adequate amount of reimbursement under this title to providers and suppliers of air ambulance services for furnishing such services that would reflect operational costs of such providers and suppliers and preserve access to critical air medical services and such other recommendations as the ,comptroller ,general deems appropriate4 7iii7 ,limitation ,the reports submitted under subclauses 7i7 and 7ii7 shall not include any information that the ,secretary or ,comptroller ,general1 respectively1 determines is proprietary4 7#ah7 ,temporary increase in payment for air ambulance services 7,a7 ,increase 7i7 ,in general ,subject to subparagraph 7,b71 in the case of air ambulance services-- 7,i7 furnished during #bjah1 the ,secretary shall provide for a percent increase of #ab percent in the base rate of the fee schedule established under this subsection for such air ambulance services2 and 7,,ii7 furnished during #bjai and #bjbj1 the ,secretary shall provide for a percent increase of #bj percent in the base rate of the fee schedule established under this subsection for such air ambulance services4 7ii7 ,application ,the increase under clause 7i7 shall apply only with respect to the year involved and the ,secretary shall not take into account such increase in computing the payment amount under the fee schedule under this subsection for a subsequent year4 7,b7 ,no increase for providers and suppliers that do not report data ,the ,secretary shall not provide for the percent increase under subparagraph 7,a7 in the base rate of the fee schedule established under this subsection-- 7i7 with respect to air ambulances services furnished by a supplier or provider of air ambulances services during #bjai1 unless the provider or supplier submits to the ,secretary cost data in accordance with paragraph 7#ag77;,a7 for such year2 and 7ii7 with respect to air ambulances services furnished by a supplier or provider of air ambulances services during #bjbj1 unless the provider or supplier submits to the ,secretary cost data in accordance with paragraph 7#ag77;,a7 and quality data in accordance with paragraph 7#ag77;,d7 for such year4 7#ai7 ,rebasing air ambulance base rate ,the ,secretary shall1 through rulemaking1 provide for an update to the base rate of the fee schedule established under this subsection for air ambulance services1 which shall be applied beginning with air ambulance services furnished during #bjba1 so that such rate reflects the actual costs of providing air ambulance services1 consistent with cost data submitted under paragraph 7#ag77;,a74 ,in carrying out the previous sentence1 the ,secretary shall ensure that the aggregate data1 methodology1 and rationale applied for determining the updated base rate shall be made publicly available through rulemaking4 ,the preceding sentence shall not be applied in a budget neutral manner4 7#bj7 ,value-based purchasing program 7,a7 ,in general ,the ,secretary shall establish an air ambulance services value-based purchasing program 7in this paragraph referred to as the ,program74 ,under the ,program1 the ,secretary shall-- 7i7 for a performance period 7as defined in subparagraph 7,f77 with respect to a payment year 7beginning with #bjbd71 determine the performance of each provider or supplier of air ambulance services1 with respect to each quality measure described in paragraph 7#ag77;,e72 7ii7 for each such performance period1 establish performance benchmarks in accordance with subparagraph 7,b72 7iii7 for each such performance period and each quality measure described in paragraph 7#ag77;,e71 establish a performance score for each provider or supplier of air ambulance services1 that is determined by measuring the performance of such provider or supplier described in clause 7i71 with respect to each quality measure described in such clause1 against the performance benchmark established under subparagraph 7,b7 for such quality measure2 7iv7 for each such performance period and provider or supplier of air ambulance services1 determine a composite performance quality score1 in accordance with subparagraph 7,c72 7v7 for each such performance period1 rank each provider or supplier of air ambulance services1 based on the composite performance quality score of such provider or supplier for such period 7as determined under subparagraph 7,c771 in order from highest to lowest2 and 7vi7 for each such payment year specify a performance payment percentage point adjustment1 in accordance with subparagraph 7,d77ii71 for each provider or supplier of air ambulance services to be applied under subparagraph 7,d77i74 7,b7 ,performance ,benchmarks ,under the ,program1 for each performance period with respect to a payment year 7beginning with payment year #bjbd71 the ,secretary shall establish a nationwide performance benchmark for each quality measure described in paragraph 7#ag77;,e74 ,such a benchmark1 with respect to such a quality measure1 shall be the average of the performance scores for all such providers and suppliers for such measure4 7,c7 ,composite performance quality scores ,under the ,program1 for each performance period with respect to a payment year 7beginning with payment year #bjbd71 the ,secretary shall determine a composite performance quality score for each provider or supplier of air ambulance services1 based on the cumulative performance scores determined under subparagraph 7,a77iii7 for such provider or supplier and performance period4 ,for purposes of ranking under subparagraph 7,a77v71 a provider or supplier of air ambulance services who does not submit required data to determine performance under this paragraph for a performance period for a year shall be treated as receiving a composite performance quality score of zero under this subparagraph for such period and shall be ranked accordingly under subparagraph 7,a77v74 7,d7 ,performance payment 7i7 ,in general ,with respect to ambulance services furnished by a provider or supplier of air ambulance services during a payment year 7beginning with #bjbd71 the ,secretary shall apply a performance payment percentage point adjustment to the percentage increase determined under paragraph 7#c77;,b71 after application of paragraphs 7#c77;,c71 7#ag77;,f71 and 7#ai7 and subparagraph 7,e7 for a payment year 7beginning with #bjbd74 7ii7 ,performance payment percentage point adjustment ,the ,secretary shall1 in accordance with clause 7iii71 specify a performance payment percentage point adjustment for a provider or supplier of air ambulance services for a payment year 7beginning with #bjbd7 which may include a zero percentage4 7iii7 ,requirements ,in specifying the performance payment percentage point adjustment for a provider or supplier of air ambulance services for a payment year under clause 7i71 the ,secretary shall ensure that-- 7,i7 such adjustment is based on the ranking of the provider or supplier under subparagraph 7,a77v7 for the performance period for such payment year2 7,,ii7 the application of all such adjustments in such fiscal year results in an appropriate distribution of performance payment incentives applied under this paragraph such that-- 7aa7 providers and suppliers of air ambulance services with the highest rankings under subparagraph 7,a77v7 receive the highest payment increases under clause 7i72 and 7bb7 providers and suppliers of air ambulance services with the lowest rankings under subparagraph 7,a77v7 receive the lowest payment increases under clause 7i71 which may include zero2 and 7,,iii7 the total amount of increases in payment under this subsection for all providers and suppliers of air ambulance services1 pursuant to this subparagraph1 in such payment year shall be equal to the sum of the total amount1 as estimated by the ,secretary1 of the reductions to payments under this subsection for such payment year pursuant to subparagraph 7,e7 and the total amount1 as estimated by the ,secretary1 of the reductions made under paragraph 7#ag77;,f77i7 and made available under paragraph 7#ag77;,f77iii77,i7 for purposes of performance payments under this paragraph for such payment year4 7,e7 ,funding for performance incentive adjustments 7i7 ,in general ,with respect to air ambulance services furnished by a supplier or provider of air ambulance services during #bjbd or a subsequent year1 the ,secretary1 after determining the percentage increase under paragraph 7#c77;,b71 and after application of paragraphs 7#c77;,c71 7#ag71 and 7#ai71 shall reduce such percentage increase for payments under the fee schedule under this subsection otherwise applicable to such provider or supplier for services furnished by such provider or supplier during such year by the applicable percent 7as defined in clause 7ii774 ,the ,secretary shall make such reductions for all providers and suppliers of air ambulance services in the year involved1 regardless of whether or not the provider or supplier has been determined by the ,secretary to have earned a performance payment percentage point adjustment under subparagraph 7,d7 for such year4 7ii7 ,applicable percent ,for purposes of clause 7i71 the term applicable percent means1 with respect to #bjbd and succeeding years1 #b percent4 7,f7 ,performance period ,for purposes of this paragraph1 the term performance period means1 with respect to a payment year1 the previous year 7or1 if specified by the ,secretary1 portion or portions of such previous year74 4